Terminally Ill Patients: A Case Study

“An ethical dilemma exists when a choice has to be made in which the consequences may have a potential positive or negative outcome.”("Topic 4: Contemporary Ethical Dilemmas (How do managers evaluate beginning-of-life dilemmas?). ", n.d.) The given scenario presents a patient named Jamilah Shah, who is of Turkish descent, 90 years old and collapsed at the side of her bed in the extended care facility in which she resides. The patient suffers from Chronic Pulmonary disease and diabetes mellitus. The patient was rushed to the ER were the EKG and lab tests revealed she suffered a heart attack and she was started on anticoagulants. The patient has no advance directives and a communication barrier exists, the ER department contacts the emergency contact, one of the patient 's sons Bashir. The patient 's family arrives at the hospital and her son states that he makes the decisions and the wants a do not resuscitate order for his mother and no medical intervention other than comfort care. The social worker handling Jamilahs case is concerned by her family 's lack of support and that the family 's wishes are at odds with the patient 's request for help and her expressed desire to live. Furthermore if the patient does not receive a cardiac catheterization or is considered for a coronary bypass, she will surely die.

I was after a while to rationalize that because these patients had no quality of life and were clinically brain dead, we were not causing any harm. Then we had a patient with Amyotrophic Lateral Sclerosis (ALS). This patient was on ventilator support, unable to move his extremities, he was able to talk and make his needs known, and was able to eat. Then one day the doctors advised the patient related to the fact he was silently aspirating he was no longer going to be able to eat, and would require a feeding tube. The patient refused a feeding tube and then terminally weaned himself off the vent. It was my duty to take care of this patient on the day of the terminal wean, which was difficult for me, because I felt as though he was committing suicide and we were assisting his efforts. For me this was no different than the hospital being a Dr. Kevorkian. I do not believe in suicide and it was very difficult to maintain and preserve his wishes even though they were totally against my beliefs and values. I had to take care of him no matter what his decision was, whether right or wrong his values led him to remove his life support. During my years as working as a floor nurse I have now developed my own sense of what I feel is ethical and humane. I believe that if a patient has already

Although the patient themselves are going through the worst of it, it also takes a toll on the family members and friends who have to watch the patient suffer. An illness in the family is never easy due to the bills and all the time that taking care of the patient takes. It is also hard for the patient to watch their family members and friends suffer and know that it is their fault. The patient should be able to end all of that suffering if it is their choice.

Some positive impacts in the death and dignity act according to apecsec.org would be that it would alleviate the patient’s suffering of the terminal illness. It is not humane to allow them to stand the intolerable pain. Another positive impact on the target population is to aid them in dying painlessly. The greatest impact I see is we allow the patient who is going through this to see their value of death and life. Keeping a life support method against the wishes of the patient, can be seen as unethical. (Death, 2014.)

Imagine having to witness a family member or even a friend on life support be kept alive while knowing that there is no chance for a cure. A patient might feel like it is their time to go, but family members might have a hard time accepting the situation and will disagree. That is why patients in those extreme situations should have the option to end their life peacefully or continuing living in the conditions they are in.

Maintaining life support systems against the patient’s wish is considered unethical both by the medical profession and the laws. Supposing a patient values the right to defer or withhold care, the same patient must have the right and privilege to end his life in order to prevent intolerable pain. The argument, which holds that family members could misuse the physician-assisted suicide rights in order to inherit wealth, are misplaced (Diekstra, 2008). This is attributed to the fact that even in the absence of physician-assisted suicide, members of a family could remove life support systems that can undoubtedly lead to the premature death of the

The current health situation should be explained in a non-technical way so the patient (if possible) family, and or valid surrogate can understand every aspect. The physician should also help them understand when there is no hope for recovery. Most often the organs are no longer functioning, or there is little to no brain activity; at this point suffering potentially outweighs the probability of recovery. Medical teams most often realize that the focus should be on comfort, rather than extending a dying life. This decision comes with a great deal of uncertainty, and will always be hard, no matter what age of the patient, or the circumstances. Kathryn Kosh, MD explains that, “Ready access to advanced modern technology has changed death from an event to a process… Defying death requires payment [in the form of] pain and discomfort or in an unacceptable decline in the quality of life.” Often times physicians will not prescribe treatment in the first place knowing that this option will not benefit the patient, prolong suffering; and will likely end in termination anyway. Therefore, allowing the nature of the illness or injury to take its own course of action. Another point of interest regarding this topic is that medical teams realize in most cases, that providing an ethical and dignified death can be just as rewarding as administering aggressive measures to save a

After reading your post and many of the colleague in the class, most agree that is not professional to disregard the conversation that the family was having. Although the patient wishes were not to remain on life support and had a document to prove it he also fail to have a proxy to carry one his whishes. The Health Care Proxy is a simple document, legally valid in many states, which allows a person to name someone (an "agent") to make health care decisions their behalf if they are unable to make or communicate those decisions. (Society, 2015).

The purpose of this paper is to examine communication strategies related to palliative and end-of-life care with a focus on Aboriginal clients. Firstly, I will explain the role of cultural competence in the nursing care of an Aboriginal client. Secondly, I will argue the cultural challenges a nurse may face when caring and communicating with Aboriginal clients receiving palliative end-of-life care. Thirdly, I will present solutions to the aforementioned communicative challenges. Lastly, I will discuss the impact I believe this experience may have on my future practice.

The Fall of The House of Usher is Gothic Literature written by Edgar Allen Poe, a famous author that specializes in Gothic literature, in September 1839. The short story follows the perspective of a nameless narrator coming to visit his sick friend Rodrick Usher and his ill-willed sister Madeline, but fate had more in store than a simple visit. Now if you haven’t read the story I recommend you do it is a very good short story coated with a thick mist of paranoia and definitely worth your time. Have you read it yet? Good I was getting bored waiting now that you have read it lets discuss details over this spine-chilling tale shall we?

I have received your letter and I would like to talk to you what is happening. I am so thankful that you are the only one happy. You are the only crayon that liked what you are doing and I would like to thank you for congratulating me on coloring things green. I think I could do it as a career like you had said. I absolutely love to color with you because after all dinosaurs, crocodiles, frogs, and trees are not supposed to be any other color. Green Crayon you are my BEST color always look'n sharp.(pun)

As an administrator I would need to take into consideration the patient’s autonomy, autonomy is recognizing an individual’s right to make his/her own decisions about what is best for them regarding their health care (Pozgar, 2012). The patient’s rights always should be considered before any decisions are made by any other family members. In this scenario it is clear that the patient is unable to make any decisions, the patient has suffered a serious brain damage, and although it is not complete brain death, we must determine how to proceed.

After reading this scenario about this patient, there are a few things that I wonder about and things that could have potentially contributed to this patient’s death. First, I do not understand why they did not place an Ewald tube down this patient and perform some sort of gastric lavage with activated charcoal (Gastric, 2017). They did all the work to stabilize the patient, but did not remove the remainder of the product, causing the acidosis. Basically, I feel that the patient came in with metabolic acidosis because of the aspirin, was stabilized, but then developed metabolic acidosis again. Which could have lead to a whole new list of complications to develop.

When a patient is unable to make decisions for himself or herself, their caregivers and those who know them are appointed to make the decisions based on what the patient would have wanted. This is called surrogate decision making. According to the article Terri Schiavo and End-of-Life Decisions “when surrogate decision makers and caregivers cannot agree upon what that choice would have been, they may turn to the courts to determine either what the now-incapacitated patient would have chosen or who is best suited to choose as the patient would have” (Mathes, 2005)

India is a vast country with rich and varied heritage. In this unique country live followers of several religions, such as Hinduism, Islam, Christianity, Jainism, Buddhism, Zoroastrianism and Sikhism.